The Secret to Staying Optimistic When You're Positive
Dear Dr. Bob: You're always giving us incredible advice about living with HIV, but how do you cope with your own HIV status? What's your secret to staying so optimistic: Your level of knowledge as a doctor? The love of family and friends? Support groups?

Is It Safe for an HIVer to Be Around Animal Droppings?
I tested positive two weeks ago, and I'm wondering how the diagnosis will impact my business. I'm a professional housecleaner, and one of the houses I clean has a large kennel with 24 dogs, three cats, a bird and a number of other boarding animals on any given day. Of course I wear gloves, but I am exposed to droppings and urine at this house. Could this exposure have a negative impact on my health now that I'm HIV positive? Would it be prudent to stop working with this client?

Giving HIV Treatment a Chance
My husband and I were shocked and frightened by our HIV diagnoses in March. At the time my CD4 count was 114 and my viral load was 98,000. I have received support from my loved ones and have wonderful medical care. I started ritonavir (Norvir) + saquinavir (Fortovase, Invirase) + Truvada (tenofovir/FTC) on May 3, and by May 24 my CD4 count was 381 and my viral load was 2,600. Wow! I feel good and have more energy. I received news this week that a friend committed suicide after testing positive. This isn't his whole story, but the diagnosis obviously tipped him over the edge. He didn't give treatment a chance and had made up his mind to die. I just wanted to tell people reading this that I did give treatment a chance, and am encouraged by my experience.

Can I Recover From a Late HIV Diagnosis?
I feel like I'm in a nightmare from which I can't wake up. I am a 40-year-old, healthy (or so I thought) gay man, and I thought I was low risk; I haven't had unsafe sex for years. But I recently had my first HIV test in many years as part of a routine physical, and it came back positive. Then I was shocked to learn that my CD4 count was only 109. There is so much I do not understand! I am suddenly on a series of medications I know nothing about, and although my doctor said that I can expect to do very well on treatment, I fear he is just trying to mitigate my shock. Is it truly possible for me to potentially still do well, given how late I have been diagnosed?

Disclosing to a Third Partner in a Mixed-Status Relationship
I'm an HIV-positive guy who's been in a 19-year relationship with an HIV-negative man. We recently met a young man who we'd like to make a permanent part of our relationship. HIV disclosure doesn't feel any easier for me now than it did 19 years ago. What's the best way for me to break the news to our new partner, and explain that an HIVer can have a serodiscordant relationship without infecting a negative partner?

No Immediate Response to My New Regimen; Should I Be Alarmed?
Two weeks after starting my latest HIV treatment regimen, a blood test showed that my CD4 count had dropped from 186 to 117, while my viral load had gone up slightly. I am extremely alarmed; I had expected big improvements, and this is exactly the opposite. My doctor, who is a well-known HIV specialist, says that sometimes the drugs take a while to kick in. But everything I've ever read says that these drugs do most of their work in the first few weeks. How unusual is what I'm experiencing? And am I justified in being scared?

Will Missing One Dose of Efavirenz Cause Resistance?
I recently had surgery (for something unrelated to HIV) and was hospitalized for two weeks. The evening I came out of surgery, I missed a dose of efavirenz (Sustiva, Stocrin) because I was under anesthesia. I then took the missed dose the following morning. I'm now concerned that taking my efavirenz off-schedule will cause resistance. My viral load is undetectable and my CD4 count is 428 -- I don't want to mess up my numbers!

Switching Due to Rising Viral Load: Is This the Right Regimen?
I have been on a combination of Combivir (AZT/3TC) + nevirapine (Viramune). My viral load has risen over my last three tests, most recently doubling to more than 12,000. As a result, my doctor wants me to switch to AZT (zidovudine, Retrovir) + ddI (didanosine, Videx) + Kaletra (lopinavir/ritonavir). I am afraid of potential side effects, especially fat loss. Do you think this is the right combination?

If I Was Once Resistant to 3TC, Can I Take Combivir?
I developed resistance to 3TC (lamivudine, Epivir) 10 years ago, but now I'm considering a new regimen that would include 3TC. Is there any risk that, if I switch to Combivir (AZT/3TC) + nevirapine (Viramune), my resistance to 3TC will cause the entire regimen to fail?

Which HIV Meds Can Cause Bone Problems?
I'm on a five-medication HIV treatment regimen, and have been feeling a lot of pain in my feet and knees. My doctors found hairline fractures in both knees and one ankle, and said that my bones are deteriorating. They think it's happening because of my HIV meds. Are they right?

Spontaneous Infection: Can I Give Myself HIV? A few months ago I thought I got HIV, because I had a wet dream while I was asleep and some of the sperm ended up around my anus. I thought that my sperm may have reacted with my feces (or something in my feces) and made HIV. Is this kind of thing possible? Is HIV only passed on through transmission of fluids with an HIV-positive person, or can you "create" it?

Visit the June 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The June gallery is entitled "Magick Eyes"; it's curated by Malik Gaines, an independent critic and curator, and Alex Segade, a film and video director.